The Supreme Court-appointed expert committee has established minimum standards for intensive care units (ICUs), specifying the infrastructure, equipment, and staffing required for a hospital to qualify as having an ICU. The framework mandates a dedicated ICU space with access to emergency services, operation theatres, and laboratories, along with power backup, sanitation, and proper layout. Bedside essentials include oxygen, suction, and electrical points, as well as equipment such as monitors, ventilators, defibrillators, crash carts, infusion and syringe pumps, glucometers, and ECG machines.
Staffing Requirements
Staffing is central to the norms. ICUs must be led by trained doctors and be manned round the clock, with higher nurse-to-patient ratios than in wards - ranging from 1:2 to 1:3 and up to 1:1 for critically ill or ventilated patients - supported by allied healthcare staff. The guidelines also emphasize continuous monitoring, life-support systems, and strict infection control protocols as essential to ICU care.
Implementation and Endorsement
The norms are part of 'Guidelines for the Organisation and Delivery of Intensive Care Services', a report drafted by a three-member committee and vetted by medical experts, and endorsed by the court as 'practical, implementable and necessary as a minimum standard for an ICU'. A bench of Justices Ahsanuddin Amanullah and R Mahadevan has asked states and Union territories to submit action plans identifying gaps and implementation strategies by May 18.
The Supreme Court-appointed panel - comprising AIIMS doctor Nitish Naik, additional solicitor general Aishwarya Bhati, and advocate Karan Bharioke - has said clinical judgment should guide decisions on the level of care required. Dr Harsh Mahajan, chairman of Mahajan Imaging Lab and one of the experts who vetted the guidelines, said it recognizes gaps in rural and remote areas and suggests measures such as interim staffing norms and linking smaller ICUs with higher centres through e-ICU or tele-ICU support.
Dr Saumitra Rawat of Sir Ganga Ram Hospital, part of the group that vetted the guidelines, said, 'The new guidelines classify ICUs into levels, making it mandatory for even entry-level units to meet defined norms.'
